For the first time as president, Donald Trump has spouted the same kind of misogynistic vitriol that was a hallmark of his candidacy, lashing out at MSNBC host Mika Brzezinski in a pair of tweets Thursday morning.

“I heard poorly rated @Morning_Joe speaks badly of me (don’t watch anymore). Then how come low I.Q. Crazy Mika, along with Psycho Joe, came…to Mar-a-Lago 3 nights in a row around New Year’s Eve, and insisted on joining me. She was bleeding badly from a face-lift. I said no!” the president fumed on Twitter.

His words were met with quick condemnation from members of his own party. Sen. Lindsey Graham wrote, “Mr. President, your tweet was beneath the office and represents what is wrong with American politics, not the greatness of America.” Sen. Ben Sasse echoed his sentiment, writing: “Please just stop. This isn’t normal and it’s beneath the dignity of your office.”

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Speaker Paul Ryan struck a similar tone when he was asked about the comments on Thursday. “Obviously I don’t see that as an appropriate comment,” Ryan said. “What we’re trying to do around here is improve the tone, the civility of the debate. And this obviously doesn’t help do that.”

Sen. Susan Collins of Maine was more forceful, writing on Twitter: “This has to stop – we all have a job – 3 branches of gov’t and media. We don’t have to get along, but we must show respect and civility.” Kansas Rep. Lynn Jenkins likewise tweeted that the president’s comments were “not okay.”

With the Republican plan to repeal the Affordable Care Act — a major campaign promise of Trump’s — is already in serious jeopardy in the Senate, increased tensions likely won’t help Majority Leader Mitch McConnell advance the legislation. (Sasse has not announced how he would vote on the proposed legislation.)

During the campaign, Trump’s sexist comments — criticizing Carly Fiorina’s face, suggesting Megyn Kelly was hormonal because she asked tough questions, retweeting derisive memes about Heidi Cruz’s appearance — were well documented. But his tweets on Thursday marked the first time that, as president, he’s engaged in such behavior.

A representative for MSNBC said in a statement, “It’s a sad day for America when the president spends his time bullying, lying and spewing petty personal attacks instead of doing his job.” (Brzezinski has not personally commented, but she did tweet a photo of a Cheerios box bearing the tagline “For little hands.”)

Trump’s blistering criticism was bewildering for at least two additional reasons: Brzezinski and her co-host and fiancé Joe Scarborough were with Trump on New Years Eve and, though he denies it, Trump himself is said to have undergone the kind of plastic surgery for which he attempted to deride Brzezinski. Trump’s ex-wife Ivana said in a divorce deposition in the early 90s that the president underwent plastic surgery in the Eighties to remove a bald spot. At the time, Ivana Trump alleged that Donald “raped” her after the surgery, which he felt was botched and blamed on her because she supposedly recommended the surgeon. Trump denies the allegations (about both the rape and plastic surgery), which resurfaced during the campaign and were first made public in the 1993 book Lost Tycoon: The Many Lives of Donald J. Trump by the journalist Harry Hurt III.